Analysis of TFC
A theory is classified as a body of principles, concepts, and/or propositions that explain a phenomenon (Merriam Dictionary, 2017). According to Fawcett and DeSanto-Madeya’s nursing framework, a nursing theory involves an objective detailed explanation which includes assessment of scope, context, and content (Fawcett & DeSanto-Madeya, 2013).
Theory Scope In the nursing discipline, concepts and propositions must be examined for quality and comprehensiveness to determine the scope of a theory. Thus, the first step is to determine what type of theory is being evaluated: grand theory or middle-range theory. A grand theory is categorized as being broad in scope (i.e. study of society), while a middle-range theory is categorized
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These social conditions consist of socioeconomic status (SES), access to flexible resources (i.e. knowledge, power, money, education, social support), ethnicity, gender, and social network. Likewise, ‘fundamental social causes’ can determine if certain populations of people can minimize their risk for morbidity and mortality because these ‘social causes’ or determinants are linked to multiple risk factors that may lead to disease progression and adverse health outcomes (Link & Phelan, 1995). Because social and economic resources are significant determinants, ‘fundamental social causes’ are linked to multiple disease outcomes and multi-risk factor mechanisms (i.e. fundamental social causes have effects on disease despite the changes in risk factors) (Link & Phelan, 1995). Moreover, TFC is derived from a concept by Stanley Liberson, a sociologist, that causality consist of ‘basic causes’ that have significant effects such as when one effect in a mechanism declines, the effect of another becomes more prominent – it’s an inverse relationship (Link & Phelan, 1995). This concept is supported by several studies that link social conditions with disease progression which will be discussed further in the evaluation …show more content…
TFC has five main relational propositions: one, ‘individual risk factors relate to social conditions that lead to disease progression’(i.e. access to healthy food and exercise to avoid obesity); two, ‘how social factors/conditions influence an individual’s autonomy’ (i.e. homeless male/female may resort to prostitution for survival despite the risk for sexually transmitted infections); three, ‘SES relates to disease’ – as some risk factors were eradicated, other risk factors emerged (i.e. people of higher SES were more knowledgeable and favorably capable to access resources that lowered their risk of acquiring diseases; four, ‘fundamental social causes’ is the directional influence between SES and disease over a change in time (i.e. with changes in disease, risk, knowledge of risks, and treatments, these conditions are transferable as health situations evolve; therefore, those individuals whom have the most resources can avoid risk and minimize disease progression); five, the reciprocal relationship between ‘resources and disease’ (i.e. knowledge, power, wealth, social support and connections impact health and determine morbidity and mortality) (Link & Phelan,
Case Study 2: What Race Has to Do with Breast Cancer Health disparities among difference race groups continue to be a public health concern. Some races have higher chances of being diagnosed to certain types of serious health conditions as opposed to others. In the United States, African-American women continue to have the highest rates of breast cancer, and at higher risk of being diagnosed at a more advance stage of breast cancer. Although, research has demonstrated that biology and genes can put an individual at a higher risk of cancer, researchers are now identifying outside factors that are affecting many more women. For example, an article released by Time “What Race Has to Do with Breast Cancer” social and culture factors, such as social economic status, can greatly determine the health risk outcome.
The lecture, led by Dr. Christian Dimaano, discussed a variety of health disparities and then went into an in depth look at Henrietta Lacks, and the use of her cells in scientific research. He described health disparities as the differences of health problems between races, lifestyles, and mental processes. This was a very interesting topic for me, as a nursing major, I hadn’t really thought about health disparities before, so it was interesting to think about all of the potentially higher health risks that can occur simply because a patients race, or mental state. He also discussed the social determinants of heath and how things like your physical environment, economic stability, social community, and education can all influence your health. Dr. Dimaano also talked about how social determinants of health are health problems that you had no choice in, they are developed by factors such as sex, age, genes, medical care, and individual behaviors such as work and home life.
Adewale Troutman stated that he advocates “individual responsibility, but always within the context of social determinants” linking the two thoughts together. Fundamentally, he is saying that it is up to one to make their health within the means they have. There are aspects of life that people have no control over or don’t have the resources to fix, but there are still ways they can improve their health. Social determinants are conditions that people grow, work, live, age and the factors that shape their daily lives.
In the following paragraphs, the grand theory of Jean Watson will be explored for its usefulness in practice. We will explore how the theory is congruent with current nursing standards and nursing interventions. Next, we will study if her theory has been tested empirically, if it is supported by research and if it is accurate. We will explore if there is evidence that her theory has been used by nursing educators, researchers, and nursing administrators. Then we will study how her theory is relevant socially and cross-culturally.
As nurses, we continue to gain knowledge and skills within our area of practice. We use theories to help us build concepts or ideas in gathering information, explaining relationships and demonstrating experiences of development. Theories vary in their level of abstraction and scope. Nursing theories are beneficial in helping us to understand, organize our thoughts and influence practice and research. Nursing theory has three distinct types to describe the level of abstraction:
Social Determinants of Health Shelly Clavis Rutgers University School of Nursing Social Determinants of Health Defined Health concerns is an issue that most organizations have formed a pact to safely deal with the challenge. The main agenda focuses on the eradication of health inequalities that may exist in most countries. It is best suited that social determinants are accorded the much-needed attention since they affect a number of people. In assessing the factors that affect one’s health, genetic disposition, personal behaviors, ability to obtain healthcare and the overall environment in which an individual resides are to be considered. Social determinants of Health are issues that deals with the conditions that people have found constructed in a society and acts as a parcel in their lives, such as; growth, age and some of the more complex systems that construct a society which include economic policies and their systems that include social norms, development goals and the basic political system that they are indulged under (World Health Organization, 2008).
The term social determinants of health, can be defined as a ‘set of conditions in which people are born, grow up, live and work.’ These conditions include housing, education, financial security and the environment along with the healthcare service. (http://www.rcn.org.uk/__data/assets/pdf_file/0007/438838/01.12_Health_inequalities_and_the_social_determinants_of_health.pdf) These factors are affected by the amount of money, power and resources that are available at a global, national and local level. Social determinants of health are linked to health inequalities according to the World Health Organisation, health inequalities are ‘the unfair and avoidable differences in health status seen within and between countries.’
Philosophy of Nursing Everyone’s values and beliefs about the profession of nursing are all different. The four concepts of nursing are interrelated and all mean something different to every person, too. Throughout this paper, I will be reflecting on my values and beliefs about nursing through the four concepts while comparing them to a nursing theorist with views that are most similar to my own.
These Social Determinants of Health may all relate to each other in some ways but may also have no relation to each other at all. However, examining them will let us determine whether this is true or not and will enable us to conclude whether specific determinants of health have an effect on others. Analyzing these determinants of health will also provide us with information that may or may not link them to specific health conditions and diseases which is an interesting area as we move forward in the industry of health and wellbeing.
The practice of nursing evolves daily from theories and philosophies that are proven by researchers, resulting in growth of the medical profession and advanced evidence based knowledge. Philosophies According to Alligood (2014b), philosophies are specific theories that focus on one or more metaparadigm concepts in a wide spectrum philosophical way (p. 43). For a person to understand philosophies it is required to understand the knowledge type, metaparadigms. Metaparadigm Metaparadigm is the vast perspective of a discipline and a way to describe a concern specifically to a profession or department (Alligood, 2014b, p.42).
The Biopsychosocial model (Suls & Rothman, 2004) is one of the earliest multi-dimensional models of the health field. This model demonstrates the interaction between biological and social factors in regard to disease analysis. It displays levels above and below a person arranged from global systems at the top and genetic systems at the bottom. In the Social and Behavioral Foundations of Public Health, Coreil (2010) describes how the biopsychosocial is more concerned with the biological systems within the human body and pays greater attention to this interplay. In the case study, Cockerham (2013) details how social conditions act as the ultimate causes of diabetes and diabetes related fatalities in the community of East Harlem.
These factors are known as the Social Determinants of health. “The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system” (WHO). Dalgren & Whitehead (1991) image of the social determinants of health aims to show the relationship between the person, their environment and their health. The modifiable factors, people’s age, gender and race lie in the centre surrounded by non modifiable factors like profession, housing, education and public policy. There is a direct relationship between people’s environment and their health, e.g. people who live in damp housing have a higher incidence of respiratory health problems (Farell et al.
Health outcomes among people depend upon the resources that people have to live a quality life. The variations with the money distribution and power derive such circumstances and induce inequalities in health at domestic and global levels where they have become unavoidable at present (Vega & Frenz, 2013). It has been stated that income, housing as well as environment are the major categories undermining all the factors of social determinants as mentioned earlier. Individuals, groups and communities are negatively influenced by these factors in their health status. Governments of all nations have undertaken several measures to tackle the risks arising from these conditions (Chapman, 2010).
Nurses fatigue is growing problem nurse face each day in the healthcare environment, and he can be caused by long hours, sleep deprivation, and possibly by accepting extra assignments can be dangerous for both nurses and patient. These inadequacies can result in major implications for the health and safety of registered nurses and can compromise patient care which can lead to fatalities. (American Nurses Association, 2014). In my experience, being fatigued from working much 12-hour shifts consecutively was very difficult as I felt extremely tired, resulting in lack of focus, missing important details during the handing over the process with impaired cognitive functioning. This I found was detrimental to the patients and myself as it impedes quality and has a deleterious effect on patient safety.
o The theory is limited to 13 sub-concepts. o It lacks the specific definitions for the concepts and sub-concepts (Dossey, 2010). • Strengths: o Nightingale’s creation of complete nursing care. o Theory’s sub-concepts are timeless.